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Clinical Risk Factors for Upper Gastrointestinal Bleeding after Percutaneous Coronary Intervention: A Single-Center
Ji-Myoung Lee1, Seon-Young Park1, Jung-Ho Choi1
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chonnam National University Medical School, Korea.
Insights
Upper gastrointestinal bleeding (UGIB) affects 1.1% of patients after percutaneous coronary intervention (PCI). History of peptic ulcer disease and anticoagulant use are key risk factors for UGIB post-PCI.
Area of Science:
- Cardiology
- Gastroenterology
- Clinical Research
Background:
- Percutaneous coronary intervention (PCI) necessitates long-term antithrombotic therapy.
- Upper gastrointestinal bleeding (UGIB) is a significant complication post-PCI, increasing morbidity and mortality.
Purpose of the Study:
- To determine the incidence of UGIB within one year following PCI.
- To identify clinical risk factors associated with UGIB in Korean patients post-PCI.
Main Methods:
- Retrospective review of 3,541 patients undergoing PCI.
- Propensity score matching (age, sex) to compare UGIB cases (n=40) with controls.
- Analysis of incidence and risk factors for UGIB within one year post-PCI.
Main Results:
- UGIB occurred in 1.1% of patients post-PCI.
- History of peptic ulcer disease (OR, 12.68) and anticoagulant use (OR, 7.76) were independent risk factors for UGIB.
- Statistical significance was observed for both risk factors (p=0.001 and p=0.002, respectively).
Conclusions:
- UGIB incidence post-PCI is 1.1%.
- Vigilance for UGIB is crucial in patients post-PCI.
- Timely endoscopy should be considered for patients with suspected UGIB after PCI.
Background/Aims:
Percutaneous coronary intervention (PCI) is often performed therapeutically, and antithrombotic treatment is required for at least 12 months after stent implantation. However, the development of post-PCI upper gastrointestinal bleeding (UGIB) increases morbidity and mortality. We investigated the incidence and risk factors for UGIB in Korean patients within 1 year after PCI.
Methods:
The medical records of 3,541 patients who had undergone PCI between January 2006 and June 2012 were retrospectively reviewed. We identified 40 cases of UGIB. We analyzed the incidence and clinical risk factors associated with UGIB occurring within 1 year after PCI by comparing the results for each case to matched controls. The propensity score matching method using age and sex was utilized.
Results:
UGIB occurred in 40 patients (1.1%). Two independent risk factors for UGIB were a history of peptic ulcer disease (odds ratio [OR], 12.68; 95% confidence interval [CI], 2.70 to 59.66; p=0.001) and the use of anticoagulants (OR, 7.76; 95% CI, 2.10 to 28.66; p=0.002).
Conclusions:
UGIB after PCI occurred at a rate of 1.1% in the study population. Clinicians must remain vigilant for the possibility of UGIB after PCI and should consider performing timely endoscopy in patients who have undergone PCI and are suspected of having an UGIB.
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